Efficacy and safety of upadacitinib in the treatment of ulcerative colitis and Crohn’s disease in real clinical practice. Experience of the regional IBD Center

The aim: of this study was to evaluate the efficacy and safety of upadacitinib (UPA) in real clinical practice in patients with ulcerative colitis (UC) and Crohn’s disease (CD) in a specialized regional Center for the Diagnosis and Treatment of Inflammatory Bowel Diseases. Material and methods. A retrospective study of patients with IBD who received upadacitinib until December 31, 2024. To assess the efficacy and safety, the study included 91 patients who received treatment at the IBD Center for at least 12 weeks or until the drug was discontinued. Data were collected from October 2022 to December 31, 2024 (from 116 to 12 weeks of therapy). The following patient characteristics were analyzed: demographic parameters, number of lines of biological therapy before initiation of UPA, severity of the disease, previous treatment, presence of extraintestinal manifestations, extent of UC lesions, localization of gastrointestinal lesions and form of CD, presence of perianal CD lesions. Results. In patients with severe and moderate ulcerative colitis and Crohn’s disease resistant to standard therapy, upadacitinib demonstrated high efficacy and safety of induction and maintenance therapy in achieving clinical and endoscopic remission. Conclusion: Our clinical observation demonstrated high efficacy and safety of induction and maintenance therapy in patients with severe and moderate ulcerative colitis and Crohn’s disease resistant to standard therapy. Upadacitinib can be considered as a drug of choice in bionaive patients with moderate to severe IBD who have unfavorable prognosis factors. Our data on the high efficacy of upadacitinib in patients with failed biological therapy indicate the need to consider it as one of the preferred options in the 2nd and subsequent lines of therapy equally in patients with ulcerative colitis and Crohn’s disease.